1902364003 NPI number — JUDY THORNTON MSW PLLC

Table of content: (NPI 1902364003)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902364003 NPI number — JUDY THORNTON MSW PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JUDY THORNTON MSW PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902364003
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/28/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10720 E 15TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPOKANE VALLEY
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99206-5586
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-979-7922
Provider Business Mailing Address Fax Number:
509-323-1607

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1303 W MAXWELL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201-2714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-747-7147
Provider Business Practice Location Address Fax Number:
509-323-1607
Provider Enumeration Date:
03/07/2019

Additional Information

Authorized Official

Authorized Official Last Name:
THORNTON
Authorized Official First Name:
JUDY
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
OWNER/PROVIDER
Authorized Official Telephone Number:
509-747-7147

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2106599 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com